| Ageless Alpha Llc | |
|
1289 S Bridgegate Dr Gilbert AZ 85296-8227 | |
| (575) 574-7338 | |
| Not Available |
| Full Name | Ageless Alpha Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1289 S Bridgegate Dr, Gilbert, Arizona |
| Authorized Official Name and Position | Jesse Cisneros Jimenez (CEO) |
| Authorized Official Contact | 5755747338 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Ageless Alpha Llc 1289 S Bridgegate Dr Gilbert AZ 85296-8227 Ph: (575) 574-7338 | Ageless Alpha Llc 1289 S Bridgegate Dr Gilbert AZ 85296-8227 Ph: (575) 574-7338 |
| NPI Number | 1730878455 |
|---|---|
| Provider Enumeration Date | 05/08/2023 |
| Last Update Date | 05/08/2023 |
| Medicare PECOS PAC ID | 5799141420 |
|---|---|
| Medicare Enrollment ID | O20230522002703 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1730878455 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Jesse Cisneros Jimenez |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1124745260 PECOS PAC ID: 6608232335 Enrollment ID: I20230601002851 |
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